The red trendline is exponential. It is created using the trendline function in professional commercially available software. As can be seen 2007 is the year when the trendline cuts below a chance of there being one death per annum in England and Wales, based on a population of 55 million.

What a straight line exponential trendline on a logarithmic graph demonstrates is that the fall in measles mortality over the 100 years of the last century has been exponential.

In simple terms this means the rate of fall in mortality has been like throwing something off a cliff and watching it go faster and faster and get smaller and smaller as time passes until you can hardly see it at all.

And particularly, the fact that an exponential trendline results in a straightline is an immensely strong indication that measles mortality would continue to fall exponentially irrespective of the introduction of vaccines.

If we look at the standard “analogue” plotted graph, as in the example immediately below, we might be able to use our judgement and decide in our opinion the vaccine made little or no difference:

[Click Graph to Enlarge – Opens In New Window]

But is there any way we might be able to tell more precisely whether vaccines had any effect? Or to put it another way, what is the position for the trend ignoring when any measles vaccine was in routine use?

So here is the same ONS data but plotted only up to 1967 – before the introduction of the measles vaccine – and with the trendline plotted forward to where the chance of mortality falls below 1 in 55 million.

Putting it simply this graph immediately below shows the rate of decline of mortality prior to 1968 and what might be the position after 1967 if things carried on as they were. So data for the years 1968 to 1999 are excluded.

Or the more complicated explanation: by eliminating data after 1967 from the graph the trendline should show the trend unaffected by any potential effect [confounding] by a measles virus containing vaccine affecting the natural rate of decrease in measles mortality associated with natural measles infection. It is intended to show the likely trend from 1967 for the future, on the assumption the same rate of fall before 1968 applied after 1967. [And we can check because we have the entire data set pre 1968 and post 1967 to do the comparison.]

[CLICK ON GRAPH TO ENLARGE IN NEW TAB/WINDOW].

Again, we still see that the year 2007 is the point at which the probability of mortality from measles infection falls below one in 55 million per annum. This is just as the graph for the data from 1901-1999 does. This seems to suggest strongly that not only did measles mortality fall exponentially before the introduction of the single measles vaccine, it continued to fall exponentially and at the same rate after – even with the position up to 1999 it might seem.

Data from the Health Protection Agency shows there have been 76,000 reported cases of measles in the UK since 1992 and no deaths in adults or healthy children from acute measles. There was one death in a 14 year old on immunosuppressant drugs for a lung condition and one in an immunocompromised child [according to the HPA] since 1992. That gives a chance of nil deaths per annum in healthy children since 1992 over the entire population of England and Wales – which is roughly 55 million – give or take – such as for annual fluctuations etc and 0.1 deaths per annum in immunocompromised children.

Prior to 2006, the last death from acute measles was in 1992.”

…….

“In 2006 there was one measles death in a 13 years old male who had an underlying lung condition and was taking immunosuppressive drugs. Another death in 2008 was also due to acute measles in unvaccinated child with congenital immunodeficiency whose condition did not require treatment with immunoglobulin. “

According to the Office for National Statistics, the 2008 death is now doubted to have been a measles death.

Regardless of these two deaths in over 20 years, the trendline on both graphs presents a fairly reliable picture showing the chance of measles mortality falling below 1 in 55 million per annum, if there were no vaccination. And we can see that by 2007 actual mortality is in line with the trend shown by the graphs.

As UK measles vaccine coverage was well below 55% in the 1970′s and early 1980s what these graphs show is not unexpected. It is claimed now that the level of vaccination coverage required to achieve the theoretical concept of herd immunity is 95%. So any lower rate of vaccination clearly was not achieving that so according to that theory, the disease would still circulate and it clearly did.

The average UK mortality between 1968 [when the single measles vaccine was introduced into the UK] and 1987 was 20 and not hundreds and was falling over that entire period at the same rate exponentially as it had been before 1968. So we can be reasonably sure mortality would certainly be expected to be well below that level as time passed – and that is what these graphs and the trendlines confirm.

Trendlines do not predict but give an indication of what might be the position. In the case of the comparison between the trend for data to 1967 and compared to the trend to 1999 can we have a reasonable degree of confidence 2007 is likely to be the year the chance of a death in England and Wales would fall below 1 [ie below 100%] if there were no measles vaccines.

What we can also say with some confidence is that measles mortality would eventually have dropped to such a low level if there were no vaccines – all else being equal.

So what is the position after 1999? If the introduction of the vaccines had any effect that effect would be to accelerate the fall which already existed – but as can be seen – we do not appear to see that clearly from the trend for the period to 1999 compared to the trend for the period to 1967.

Here is Health Protection Agency data covering the period from 1948 to 2008. This data plotted identically shows exactly the same thing as the 1901-1999 and 1901-1967 data with one difference:

[CLICK ON GRAPH TO ENLARGE IN NEW TAB/WINDOW].

The trendline for the HPA data drops below a chance of 1 in 55 million by 2000. This is not like the 1999 data in the other graph which does this by 2007. So on a very simple approach that might be interpreted as indicating the vaccine might have had some effect in accelerating a reduction in what is admittedly an already very low and continuing to fall rate of mortality. That of course might not necessarily be the case but it can at least be a working hypothesis.

It is of course impossible to prepare a logarithmic graph with zero values [there is no zero for a log graph]. For years which the HPA data had zero deaths it was necessary to substitute a value to plot logarithmically. 0.1 was used for this purpose.

With mortality as low as it was in the 1980s, one question which this data does raise therefore is whether it would be better for public health to have had an effective treatment for measles instead of or in addition to mass vaccination programmes – say like a measles pill.

It looks an attractive proposition, potentially taking away the problem of mass population disease control and providing a means to save third world lives. Third world children die despite the existence of vaccines and there is no effective treatment to save their lives. So western nations have been extremely selfish in failing to address that omission.

What we must always bear in mind when considering graphs of this kind which do not rely on reported cases – incidence – is that reported cases prior to 1994 in the UK are wholly unreliable as an indication of true levels of incidence of a disease. Doctors over-diagnose and have over-diagnosed measles by 74 times – for every real case there can and have been 73 non measles cases reported as measles: the data supporting this is set out here – Vaccines Did Not Save Us – 2 Centuries Of Official Statistics.

In times of panic especially any rash might be reported as suspected measles and that is likely to be happening now in South Wales, UK.

Putting it simply this graph shows the rate of decline of mortality prior to 1968 and what might be the position after 1967 if things carried on as they were.

EDITORIAL:

Having blamed Dr Andrew Wakefield for the current measles outbreak, the media and health officials telegraphed their intention last Sunday to blame him for the first UK death from measles for some years eg. First death feared in MMR scare The Sunday Times By Mark Hookham 14 April 2013.

It is not known whether the man did have measles or died from it nor whether he had been vaccinated. An omission from early reports today is why anyone suspects a measles infection. Nothing is said which is somewhat odd.

This man would have been around 18 months old when the MMR vaccine was introduced so could well have been vaccinated then. But it is not so easy to blame Dr Wakefield. The suspected but unconfirmed measles victim would also have been 10 years old when Dr Wakefield came on the scene in 1998. A post-mortem is expected to be carried out later to confirm the cause of death, according to police and public health officials say the news reports.

This situation has occurred despite UK vaccination rates being at an all time high and despite the majority of measles cases being in the 1 to 5 age group as confirmed in Parliament by Lord Howe.

If this man has died as a result of measles then the people clearly blameworthy are Dr David Salisbury and the Joint Committee on Vaccination and Immunisation. Ever since 1998 they purposefully and intentionally took away the sensible option of allowing those parents who did not trust the MMR vaccine or government assurances to have access to a single measles vaccine.

With MMR vaccination rates claimed to be at well over 90% and approaching 95%, there is a small minority of less than 10% not availing themselves of the MMR vaccine. So if there are parents who did not then and now still do not trust Dr Salisbury and the JCVI over the MMR vaccine – and they have good reasons not to – they are a minority who have been deprived of single measles vaccines since 1998 when Dr Salisbury and the JCVI oversaw the withdrawal of the option of single vaccines then.

So to get the coverage up higher would only take having an option of a single measles vaccine for between 3% and 5% of the remainder. That could easily have been achieved across the entire EU but instead health officials did nothing about it – leaving those parents and their children with nothing.

It was government saying to parents its “our way or the highway” – which is a dangerous precedent politically to set over any aspect of healthcare. No choice and no freedom.

But a policy of choice would see higher combined rates of uptake with those few families taking the single measles vaccine. The long sought and repeatedly W.H.O. postponed nirvana for public health policy of the eradication of measles in the UK could have been achieved a decade ago if not for Professor Salisbury and his JCVI. This post would not be being written now.

It is clearly nonsense to blame Dr Wakefield for something which has solely been within the control of Dr Salisbury and the JCVI for a decade and a half. Dr Wakefield did not decide to withdraw the vaccine – Dr Salisbury and others did, so they must accept responsibility for their own decisions and stop trying to scapegoat others. They have sat back complaining about vaccination uptake for 14 years with the sensible option available to them throughout.

And politically, what is the role of the state in public health matters affecting individual children and their families? At what point is the State justified in intervening? Should parents have the right to decide wisely or not on matters affecting the health of their children. Should the state override and intervene and if so, when and to what degree? Can the state be trusted to? Or more to the point, can those officials entrusted with the task be?

Or should the State facilitate by offering choice in a matter so important that choice could be the only and best sensible approach – common sense prevailing.

Health officials and the media were hedging their bets in trying recently to pin a feared death on Dr Wakefield last weekend. There have been 76,000 reported cases of measles in the UK since 1992 but only two deaths since then from acute measles and none in healthy children:

Prior to 2006, the last death from acute measles was in 1992.”

…….

“In 2006 there was one measles death in a 13 years old male who had an underlying lung condition and was taking immunosuppressive drugs. Another death in 2008 was also due to acute measles in unvaccinatedchild with congenital immunodeficiency whose condition did not require treatment with immunoglobulin. ”